Healthcare Provider Details

I. General information

NPI: 1487293965
Provider Name (Legal Business Name): ALEKSEY ZHUCHKAN PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/31/2019
Last Update Date: 12/31/2019
Certification Date: 12/31/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 E 38TH ST FL 5
NEW YORK NY
10016-2772
US

IV. Provider business mailing address

333 E 38TH ST FL 5
NEW YORK NY
10016-2772
US

V. Phone/Fax

Practice location:
  • Phone: 646-501-7077
  • Fax: 646-754-9510
Mailing address:
  • Phone: 646-501-7077
  • Fax: 646-754-9510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number038428
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: